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Putting big mouths and big ideas behind microphones.
The Physio Matters Podcast – Clinical Gold Delivered Direct.
Episodes will feature expert, honest advice, delivered directly to listeners at no cost. Musculoskeletal and Sports Medicine information for those working in physiotherapy, sports therapy, sports rehabilitation, medicine and all divisions of the healthcare industry.
Copyright: © Jack Chew
In this episode of Chewing It Over, Jack speaks with Nick Ilic about shockwave therapy, clinical uncertainty, and the problem with taking overly confident positions in MSK practice.
Nick argues that shockwave is only really “shocking” when clinicians either oversell it as a powerful long-term solution or dismiss it entirely without proper consideration. Much of the conversation sits deliberately in the middle ground: shockwave may have a role, but the evidence does not support grand claims across broad MSK conditions.
The discussion explores the tension between proposed mechanisms and clinical outcomes. Shockwave is often described as creating a pro-inflammatory or mechanotransductive stimulus, potentially “restarting” a repair process in chronic tissue. However, Nick is cautious about mechanistic certainty, noting that many MSK interventions have attractive theoretical explanations that become far less convincing when tested rigorously.
They also discuss how shockwave may simply act as another form of neuromodulation, particularly when outcomes appear similar between focused and radial approaches, or when benefits are mainly short term. Nick is especially critical of “condition creep,” where a modality gradually becomes marketed for more and more problems despite limited supporting evidence.
Importantly, he does not dismiss shockwave altogether. He acknowledges stronger evidence for indications such as calcific tendinopathy and non-union fractures, where the mechanism and evidence appear more plausible. But for common tendinopathies and broader pain presentations, he remains sceptical of inflated claims, especially when patients are paying privately.
Overall, this is a funny, sharp, and thoughtful conversation about evidence, uncertainty, informed consent, and why clinicians should be wary of both hype and lazy scepticism.
5 clinical/professional takeaways
In this episode of Chewing It Over, Jack speaks with Wesley Clark Sullivan about Medimo, a marketplace designed to make private MSK care easier to find and book. The central idea is simple: in most sectors, people are used to consumer-friendly platforms like Booking.com, Uber, or Deliveroo, yet private healthcare still often relies on clunky directories, fragmented websites, and high-friction booking journeys.
Wesley explains that the idea emerged from his background in marketing and e-commerce, combined with insight from private insurance pathways where even approved patients often fail to complete the final step of actually booking care. That gap led him to spot a wider opportunity: a marketplace that helps patients search by postcode, compare options, view live availability, and make an appointment quickly.
A major theme of the conversation is fairness and visibility for clinics. Smaller independent practices often do not have the time, budget, or expertise to compete with bigger players in SEO, paid advertising, or constant social media output. Medimo aims to level that playing field by acting as a neutral marketplace where clinics can be found more easily, without needing large marketing budgets.
Jack explores both the promise and the risks of this model, including concerns around patient data, platform dependency, and whether the service might simply intercept patients clinics would have acquired anyway. Wesley responds by outlining Medimo’s approach to data security, its free-to-list structure, and its revenue model based only on the first appointment.
Overall, the episode is about improving patient access while helping clinics reach the right people more efficiently, without compromising trust or standards.
https://medimo.co.uk/
In this episode of Chewing It Over, Jack speaks with Jim Carr from EOS Active about a part of MSK practice that often gets overlooked or handled poorly: the relationship between products, pathways, branding, and patient communication.
Although EOS Active technically sells products into the MSK space, Jim is clear that he does not want to be seen as simply “selling injections.” Instead, he argues that products only make sense when they are nested within a wider, well-reasoned patient pathway. An injection, brace, cryotherapy device, or sleeve is not the story in itself; it is only one possible component of a longer management process shaped by rehabilitation, education, timing, and patient context.
A major theme of the conversation is that clinics often inherit their marketing language from manufacturers without fully realising it. Glossy flyers, miracle-style testimonials, and product-led messaging can slowly become part of a clinic’s identity, even if they do not reflect how that clinic actually wants to practise. Jim’s answer is to help clinics present information in a more neutral, patient-centred way that supports trust rather than hype.
The discussion also explores why Jim feels unusually aligned with private clinics. He sees parallels between building a distribution business and building a clinical service: both require strategy, long-term thinking, and careful management of brand and reputation. Rather than pushing the newest thing, he prefers established, sensible options that fit real-world practice.
Overall, this episode is about thinking beyond transactions. It asks clinics to be more intentional about what they communicate, how they communicate it, and how commercial choices shape the care experience patients receive.
Cingal® as a multi-joint injection is now EU MDR certified.
The certification includes expanded indications for multiple synovial joints, including the knee, hip, shoulder and ankle, supporting broader clinical application.
As part of the MDR transition, the manufacturer is completing the final administrative steps to ensure update IFUs and supporting documentation are available in line with regulatory requirements. Further information will be shared in due course. Eos active as te UK partner are preparing updated marterials allowing you to communicate appropriatley with patients in clinic and can answer questions and quiries about this recent update.
In this episode of Chewing It Over, Jack speaks with Finn Stevenson about Flok Health and the idea of an AI physiotherapy service for back pain. Finn frames the problem clearly: in musculoskeletal care, especially within the NHS, the issue is often not knowing what works, but getting timely access to the care that already exists. With demand rising faster than workforce growth, traditional one-to-one care models struggle to keep up.
Finn explains that Flok is not positioned as a software tool sold to clinicians, but as a regulated clinical service that combines AI with remote human physiotherapy support. Its current focus is spinal pain, particularly the large group of patients who can benefit from personalised exercise, reassurance, behaviour change support, education, and psychologically informed care. The ambition is to automate large parts of the pathway safely and consistently, while freeing face-to-face clinicians to focus on more complex cases.
A major part of the conversation explores how this works. Finn distinguishes Flok’s system from standard large language model chatbots, arguing that healthcare needs much tighter behavioural control. He describes a rule-based clinical reasoning system combined with a video-based interaction model built around “Kirsty,” a real physiotherapist whose filmed responses are assembled in real time to create a more human and engaging consultation experience.
The discussion also tackles controversy: what counts as “physiotherapy,” whether this threatens the profession, and what happens when technology enters clinical care at scale. Jack remains probing but open-minded, while Finn argues that the bigger ethical issue is leaving patients stuck on long waits for care we already know how to deliver.
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In this episode of Chewing It Over, Jack speaks with Andrew Walton, offering what Andrew describes as “a view from the top” of healthcare leadership and professional practice .
The conversation explores Andrew’s career journey and the lessons that come from working across clinical practice, leadership roles, and wider healthcare systems. Rather than focusing purely on clinical skills, Andrew highlights the importance of systems thinking, collaboration, and understanding the broader context in which healthcare operates.
A key theme of the discussion is the gap that can exist between frontline clinicians and decision-making structures. Andrew reflects on how leaders must balance competing pressures: workforce constraints, service demands, financial limitations, and patient outcomes. From this perspective, clinical excellence alone is not enough — meaningful change requires clinicians to engage with the organisational and strategic dimensions of healthcare.
Jack and Andrew also discuss how clinicians can develop leadership capabilities throughout their careers. Leadership is not framed as a job title but as a mindset and responsibility, where clinicians contribute to improving services, supporting colleagues, and advocating for better patient care.
Importantly, Andrew emphasises that leadership roles can feel distant or inaccessible to many clinicians. However, understanding how decisions are made — and how clinicians can influence them — helps bridge the gap between policy, management, and clinical practice.
Ultimately, the episode offers a reflective look at the profession from a strategic vantage point, encouraging clinicians to think beyond individual patient encounters and consider their wider role in shaping healthcare systems.
In this episode of Chewing It Over, Jack is joined by Hannah Poulton to explore a topic that clinicians encounter frequently but often feel underprepared to manage: scars and their rehabilitation .
The conversation examines the wide-ranging impact that scars can have on patients. While scars are often thought of as purely cosmetic issues, Hannah explains that they can influence pain, movement, tissue sensitivity, and psychological wellbeing. Depending on their depth, location, and the tissue layers involved, scars may contribute to stiffness, restricted movement, or altered sensory responses.
Hannah discusses how clinicians should approach scar management from a broader perspective rather than focusing solely on appearance. Scar assessment involves understanding tissue behaviour, mobility, and sensitivity as well as recognising the emotional and psychological significance scars can hold for patients.
The discussion also highlights common misconceptions around scar treatment. While many manual techniques and topical approaches are promoted in practice, the evidence base remains mixed, meaning clinicians must combine available research with clinical reasoning and patient goals.
Importantly, Hannah emphasises the value of early education and patient empowerment. Helping patients understand how scars mature, adapt, and respond to loading can reduce fear and improve engagement with rehabilitation.
Ultimately, this episode reframes scars not simply as marks on the skin, but as dynamic biological structures that interact with movement, sensation, and patient experience. With thoughtful assessment and a patient-centred approach, clinicians can play a meaningful role in improving both function and confidence for people living with scars.
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Which dynamometer should you buy? The answer is… it depends.
In this episode of Chewing It Over, Jack speaks with Dr Claire Minshull about the rapidly growing world of force measurement tech in rehab and MSK practice .
We discuss:
• Why “just buy the one your mate has” is risky
• Sampling frequency (Hz) — and why it matters for RFD
• Load capacity vs intended use
• Calibration, data fidelity & measurement error
• Why handheld dynamometry increases variability
• External fixation and reducing clinician error
• The myth of chasing normative values
• Building your own in-clinic strength database
Claire also introduces WhichDynamometer.com — a free, side-by-side comparison tool built after over a year of collecting technical specifications directly from manufacturers.
This episode is essential listening for:
✔️ Physiotherapists
✔️ Sports rehab clinicians
✔️ S&C coaches
✔️ Clinic owners making capital purchases
✔️ Anyone wanting to use objective data properly
Force measurement isn’t a magic bullet — but used well, it can enhance decision-making, patient confidence, and rehabilitation progression.
💬 Do you use dynamometry in your clinic?
What matters most to you — price, portability, sampling frequency, or something else?
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For all Claire's info - getbacktosport.com
In this episode of Chewing It Over, Jack is joined by Andy Thomas, founder of Physiquip and host of the Real Health podcast, to discuss his new book Real Growth and the thinking behind it. Rather than presenting another abstract business or personal development manual, Andy explains that Real Growth is built from real conversations, real careers, and real lived experience, drawn from more than 200 long-form podcast interviews across sport, healthcare, and business .
The discussion explores why “real” growth matters. Andy contrasts authentic development with surface-level metrics and performative success, arguing that growth is rooted in values such as authenticity, positivity, humility, enjoyment, and reflection. The book weaves together insights from elite sport practitioners, clinicians, business leaders, and entrepreneurs, showing how lessons learned in one domain often translate powerfully into others.
Andy describes the challenge of turning hundreds of conversations into a coherent structure, ultimately creating 30 short, accessible chapters grouped into themes. Each chapter ends with reflective questions designed to help readers apply insights to their own lives and work. The format mirrors how Andy himself learns: practical, digestible, and easy to dip into.
The conversation also links Real Growth to Andy’s wider work with Physiquip. He explains his belief that profitability, trust, and purpose are not opposites, but essential ingredients for sustainable healthcare businesses. Technology, he argues, is not about novelty, but about fit—supporting a clinic’s vision rather than defining it.
Overall, this episode is a thoughtful reflection on growth as a human process: built through curiosity, connection, optimism, and doing meaningful work well over time.
In this episode of Chewing It Over, Jack is joined by Heather Mclellan, physiotherapist, occupational health specialist, and founder of The Return to Work Mentor, to explore a largely invisible gap in healthcare: what happens when people—especially small business owners and the self-employed—become ill or injured and have no access to occupational health support.
Heather explains that while large organisations often have structured return-to-work systems, most UK workers are employed by micro-businesses with fewer than ten staff, where occupational health simply doesn’t exist. As a result, people are left to “chance it”: either staying off work longer than necessary due to fear and uncertainty, or returning too early without a plan, risking relapse or failure.
The conversation becomes deeply personal as Heather shares her own experience of suffering a rare stroke caused by an underlying blood cancer. Despite decades of expertise in vocational rehabilitation, she found herself navigating illness, identity, and work with virtually no formal support. Even income protection policies failed her—not because she lacked cover, but because she hadn’t “played the game” correctly by formally stopping work and obtaining a sick note.
Together, Jack and Heather unpack the emotional, cognitive, and financial strain of trying to hold a business together while managing a life-changing diagnosis. They discuss how performance, identity, and responsibility often mask distress, and why pathway-based or insurance-led systems routinely fail people at their most vulnerable.
Heather introduces her “before, during, after” framework for health crises, which underpins The Return to Work Mentor. The goal is simple but powerful: to give people calm, practical guidance—direct to the individual—so they’re not left alone to navigate one of the hardest transitions of their working lives.
In this episode of Chewing It Over, Jack is joined by Rosie Sexton — osteopath, former MMA fighter, academic, and commentator — for a deep, nuanced conversation on “reasonable adjustments”, neurodivergence, and where workplace accommodation becomes ethically, practically, and emotionally complex.
The discussion is sparked by a satirical MSK Mag article, Unreasonable Adjustments, written under the Glenohumeral pseudonym. Rosie explains why the piece felt frustrating and harmful to her: not because unreasonable adjustments don’t exist, but because satire can slide from critique into reinforcing stereotypes, particularly around neurodivergence. She highlights how portrayals of “comfort-seeking” or “trend-driven diagnoses” can discourage people from requesting adjustments that would genuinely allow them to work better and avoid burnout.
Jack responds by situating the article within its satirical intent and wider editorial context, acknowledging both its provocations and its blind spots. A central tension emerges: how do we hold space for individual needs while also recognising system-level constraints, particularly in under-resourced environments like the NHS?
Both agree that unreasonable requests can exist — but they strongly resist framing this as neurodivergent staff versus patient care. Instead, they explore how adjustments can conflict with one another, how severity and context matter, and why careful, good-faith conversation is essential. Rosie argues that dismissing needs as “trivial” is dangerous, while Jack reflects on the uncomfortable reality of triage, scarcity, and competing demands.
This episode doesn’t offer neat answers. Instead, it models something rarer: a respectful, intellectually honest disagreement, showing how complex issues can be explored without shutting conversation down.
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